Mobile & Migrant Strategy

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On 27 March 2014, after three years without any polio case, India was officially certified polio free. India’s incredible achievement was the result of strong leadership and commitment of the Government of India and core polio partners: UNICEF, WHO, Rotary International and US Center for Disease Control and Prevention (CDC), CORE and donors such as Bill and Melinda Gates Foundation, USAID and Japan. Ultimately, it was the determination by all to reach every single child and community ownership that has kept India polio free.
The United Nations Children’s Fund (UNICEF) polio program focuses on reaching the most vulnerable, migrant, mobile, underserved and marginalized children in high risk and hard to reach communities. UNICEF’s Social Mobilization Network (SMNet) with over 7,300 community mobilizers and around 55,000 influencers have worked tirelessly to make India polio free. Every national polio round, the SMNet reaches 2.2 million children in some 3 million households. In 2014, transit vaccination teams vaccinated 100,000 children on trains and over 2.5 million children at festivals.
In the post certification era, UNICEF continues to work closely with the Government and other partners to maintain zero polio and boost immunity through routine immunization, polio vaccination and other convergent health initiatives.

The India Polio Program is an amazing public health achievement that many did not think possible in 2009 with India contributing over half of the global polio cases. With polio free certification in 2014, India is now poised to take on the crucial challenge of applying the legacy of the polio program to other convergent health strategies, and to other
locations in India.
The state governments are preparing to transition polio assets such as the Social Mobilization Network (SMNet) to a government owned, funded and managed setup. The program is transitioning in scope programmatically, geographically, financially and in its
human resources management. We are witnessing legacy in action on the ground, applying these assets
in routine immunization (RI) and other convergent activities, and documenting the lessons for India and
global learning.

Overview of the key strategies:
Leadership and Partnerships: Leadership and commitment at the national, state and local government levels with role clarity among core polio partners to avoid duplication and maximize synergies; and strong partnerships built on trust with local
religious leaders, community influencers, NGOs and the media. This made it a people’s program.
Planning and Strategizing: Using data to identify and map continually missed groups and communities; and ensuring micro-plans reach every household and every child.

This document provides an overview of how vulnerable social high-risk groups are tracked and mobilized in Uttar Pradesh – who are these vulnerable social groups, their specific characteristics and traits, key heath determinants etc. Based on experiences and field observations, three major vulnerable social high-risk groups have been identified in this document – nomads, slum dwellers and migrants. The document is a primer for district level functionaries of the SMNet and helps build their understanding of these groups, for planning and implementing specific interventions so as to ensure all children under 5 years from these groups and communities are vaccinated against polio.

This document describes the high-risk groups for the polio programme in Uttar Pradesh – who are they, where do they stay, their livelihood, specific characteristics, etc. Based on recent epidemiology and case analysis, the following four groups have been identified as the most vulnerable to polio virus transmission - brick kiln and construction workers, nomads, temporary and permanent slum dwellers and underserved communities. These common working definitions have been developed basis existing research and evidence, as well as programme monitoring data and are used by all polio programme partners to track, identify, cover and monitor these groups.

A leaflet for transit mobilizers in Bihar with key points on their roles and responsibilities. It also has key 'do's and dont's' and instructions for them on how to interact with parents of children under 5 years they see travelling.

This form tracks where the children in migrant families are going when they miss out on polio vaccination. Community and block mobilizers speak to migrant parents when they return to Uttar Pradesh or Bihar. They find out where they have come from, and whether their children received the oral polio vaccine when they were interstate. The form is filled out by the BMC with inputs from the CMC. The results show which locations outside UP and Bihar should be targetted for extra polio vaccination efforts. The results are used to inform government policy.

Key findings of the migration study in five non-polio-endemic states. Migrants who move in and out of Uttar Pradesh and Bihar are asked about polio, routine immunization and current practices. The findings are used to inform the programme, in particular the mobile and migrant strategy. This is a pdf version of a power point presentation, showing the key findings.

Final report from a migration study conducted in 5 non-polio–endemic states of India (high risk states for polio) among high risk groups/ migratory/ unsettled population groups who keep moving in and out from UP and Bihar. The study investigates their knowledge on polio, routine immunization and asks about current practices. The findings have been used to direct the programme, especially the mobile and migrant stategy.

Truck back panels on polio with 3 different messages on different panels. The message on the 1st panels reads, ‘your love is complete only when your child gets polio drops every time’. The 2nd panel reads, ‘first 5 years, polio drops for my child every time’. The 3rd panel reads, ‘wherever you go, wherever you are, get your child polio drops every time’. The 4th panel has this message in Nepalese too. The polio campaign logo is given on the right side which reads, ‘protection from polio, two drops for my child every time’.
Primary message: polio vaccination

Auto rickshaw panels on polio with the message, ‘first 5 years, polio drops for my child every time’. The message on the second auto reads, ‘wherever you go, wherever you are, get your child polio drops every time’. The polio campaign logo is given at the right side bottom which reads, ‘protection from polio, two drops for my child every time’.
Primary message: polio vaccination

Hoarding on polio showing a couple travelling with their children, one of which is a baby and a vaccinator giving polio drops to the baby. The main slogan reads ‘wherever you go, wherever you are, get your child polio drops every time’. The polio campaign logo is given below the main slogan which reads, ‘protection from polio, two drops for my child every time’. Along the bottom it reads ‘first 5 years, two drops for my child every time’.
Primary message: polio vaccination

This is a map prepared by a Block Mobilization Coordinator (BMC) of a critical urban area of Moradabad in Uttar Pradesh, known as zone 7. It is used by the BMC track the flow of migrants in and out of a high risk area. This map shows nomadic sites in red, slums in green and a construction site in pink. It also shows the names of informers who let the BMC know when a nomadic group arrives or leaves the area. The map also shows the location of a health centre, Angadwadi centre, mosques, mandirs and schools.

This is an example of a hand drawn map, prepared by a Block Mobilization Coordinator (BMC). This particular map is of the block of Bhopura in Ghaziabad, Uttar Pradesh. It shows the locations of construction sites, areas where nomads are living and slums. Residents of these locations are transient, and the BMC has to make sure they are included in the microplan for polio immunization, routine immunization and that they have access to services. The map also marks villages, roads and the health centre. It is updated by the BMC as new sites appear.

This is a map of a high risk area with many construction sites, drawn by the Block Mobilization Coordinator (BMC). This map is of an area in Ghaziabad, Uttar Pradesh. The BMC carries it and uses it to plan immunization activities. From the map, the BMC knows the key sites to be visited and how far each construction site is from health services. It is constantly updated by the BMC, when new construction sites spring up.

Cinema slide on polio with a couple and their baby. The main slogan reads ‘wherever you are, wherever you go, get your child polio drops every time’. The polio campaign logo is given at the right side top which reads, ‘protection from polio, two drops for my child every time’. Along the bottom it reads ‘first 5 years, get your child two drops every time’. This slide is displayed by cinema halls before or during the interval break, during a polio round.
Primary message: polio vaccination